MEDICARE: DR. DAN RICHARD RIESLING D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8014	FL

General Provider Information

NPI Number	:	1568699189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN RICHARD RIESLING D.C.

Provider Business Mailing Address
First Line	:	1244 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3720
Country	:	US
Telephone Number	:	727-937-2086
Fax Number	:	727-939-2554

Provider Business Practice Location Address
First Line	:	1244 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3720
Country	:	US
Telephone Number	:	727-937-2086
Fax Number	:	727-939-2554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	06/22/2009

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